Inspection on 06/03/07 for Fairview Lodge

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Fairview Lodge 6 Knowles Hill Road Newton Abbot Devon TQ12 2PL Lead Inspector Judy Hill Unannounced Inspection 6th March 2007 9:35am Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairview Lodge Address 6 Knowles Hill Road Newton Abbot Devon TQ12 2PL 01803 882296 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Peninsula Autism Services & Support Limited Miss Emma Jane Holman Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection NA Brief Description of the Service: Fairview Lodge was registered in September 2006 to provide accommodation and care for a maximum of three people in the registration category of Learning Disability and specialises in providing a service for adults who have autistic spectrum disorder. The home is situated within half a mile of the town centre, which is served by bus and mainline railway services. Private transport facilities are made available for the service users. Information about the service is available on request from the Home in the form of a Statement of Purpose and Service Users’ Guide. Inspection reports will also be made available from the Home or can be accessed through the CSCI Website (www.csci.org.uk). Fees will be based on the individually assessed needs of service users and for the current service user these are £2879.91 per week. Extra charges are made for car mileage (46p a mile), professional hairdressing, chiropody, clothing and other items of a personal nature. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection carried out at Fairview Lodge since the service was registered in September 2006. There is currently only one service user and because of her needs the manager was given twenty-four hours notice of the inspection. This Key inspection was carried out on 6th March 2007 by one inspector. The information contained in this report was gained from pre-inspection questionnaires completed by the registered manager, nine members of staff and a social worker. Additional information was gained in conversation with the registered manager and three members of staff, but not with the service user, who declined to participate, from a partial tour of the premises and from records, including service user assessments, care plans and reviews and staff recruitment and training records. What the service does well: The pre-admission needs assessment was seen too be detailed and comprehensive so prospective service users can be confident that their needs will be properly identified. Very detailed care plans; risk assessments, risk management strategies and reviews were seen to have been carried out. The quality of the assessment and care planning enables the service provided to be designed to meet the individual needs of the service user. The service users occupational, recreational and social needs are included in the care planning process and help and encouragement is provided to ensure that the service users lead active lives. The service users are helped to maintain family and personal relationships. Services users dietary likes and dislikes are recorded and choices are offered at every mealtime. Healthy eating is encouraged, but not too rigidly. The help provided with personal care is based on the assessed needs of the individually assessed needs of the service user. This enables service users to maintain and develop their independence. Trained staff administer prescribed medication safely and conscientiously. The complaints procedure is accessible and complaints and concerns will be dealt with appropriately. Policies and procedures are in place and staff training is provided to protect service users from the threat of abuse. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 6 The premises are well maintained, comfortably furnished and attractively decorated and kept clean to ensure that the service users have a pleasant home environment. Safe staff recruitment practices are used to ensure that unsuitable staff are not employed to work with the residents. Good staffing levels are maintained and these are based on the assessed needs of the service user. Most of the staff have achieved or are working towards gaining National Vocational Qualifications in Care. Good induction and on going training is provided for the staff and they are well supervised. The registered manager is experienced and well qualified for her role. She is well supported by the registered service providers. Written policies and procedures are in place to ensure that safe working practices are understood and followed. The home is well maintained and kept safe for the service users. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be confident that they will be given the information they need to make an informed choice about whether or not the service is right for them. EVIDENCE: The home has a Statement of Purpose and a draft Service User’s Guide. A personalised Service User’s Guide is being developed in a format that is suitable for the service user. An inspection of records kept at the home showed that a detailed needs assessment had been obtained for the service user from Devon NHS Trust prior to admission. A further comprehensive pre-admission assessment that had been carried out by the service providers was also seen. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Very detailed care planning is carried out and service users can be confident that the service provided will be designed to meet their needs. EVIDENCE: Very detailed and well thought out care plans, reviews, risk assessments and risk management plans were seen in the service users case file. Evidence was seen to demonstrate that the needs and abilities of the service user had been taken into account where decisions need to be limited. Evidence was seen to demonstrate that the service user had been actively involved in the care planning process. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that they will be given support and encouragement to lead active lives. EVIDENCE: Peninsula Autism Services & Support employ an Educational Programmes Coordinator to work with the manager, staff and service user to develop educational, occupational and social activity programme to meet the individual service users needs. Records were seen to demonstrate that the activities programme for the service user is developmental and that it covers a range of different activities. These include short holidays, sporting activities as well as routine activities such as shopping and visiting cafés. Details of family relationship and contact were seen in the service users file. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 11 The service user is encouraged to develop and maintain everyday living skills by participating in household tasks. A record is kept of the service users dietary likes and dislikes and a choice of meals is offered. A record of food provided is kept and healthy eating is actively encouraged. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their individual health and personal care needs will be assessed and met. EVIDENCE: An inspection of care planning showed that the level of personal care provided for the service user to assist with personal hygiene is based on her assessed need. The staff monitor the physical and psychological well-being of the service user on a daily basis and evidence was seen in the form of written records to demonstrate that timely referrals are made to the appropriate primary and secondary health care services. Good contact is maintained with specialist support services. The assessment of the service users needs demonstrates that assistance is needed with medication administration. The storage of medicines is good but some clarification is needed to identify PRN medicines on the medication Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 13 administration record sheets. Information sheets were seen to enable the staff to know about the medicines they are administering. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their complaints will be taken seriously and acted upon and that they will be protected from the threat of abuse. EVIDENCE: The complaints procedure is available a written and pictorial formats and displayed in the home. The registered manager said that no complaints had been received. The registered manager has received training to enable her to train the staff on Adult Protection issues. A very comprehensive manual of policies and procedures on adult protection and the prevention of abuse was seen at the home and the staff are asked to sign a record stating that they have read and understand them. Questionnaires completed and returned by nine members of staff provided further evidence that the staff are aware of these issues. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that the home will provide a comfortable environment for them to live in. EVIDENCE: A partial tour of the premises was carried out. The parts of the home currently in use were seen to be comfortably furnished, attractively decorated, clean and well maintained. The occupied bedroom and bathroom as the service user did not choose to be actively involved in the inspection and her wishes were respected. Two unoccupied bedrooms and their shared bathroom facilities were seen to be suitable for their intended for purpose. There are two additional rooms that, it is understood, may be converted into further bedrooms at a later date. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 16 The communal lounge, dining room are spacious and well presented and the kitchen, laundry and staff accommodation are suitable for these purposes. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their needs will be met by well trained and well supervised staff and that unsuitable staff will not be employed. EVIDENCE: Questionnaires completed and returned by nine members of staff provided evidence that safe recruitment practices had been used, that induction and ongoing training is provided and that management support and supervision is good. Records were seen of the recruitment procedures used and these were seen to be safe. Records were also seen of staff induction training and on-going training. The registered manager said that she plans to carry out six monthly work appraisals with each member of staff and records of appraisals that had already been carried out were seen. Records were also seen to provide evidence of regular formal supervision. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 18 Records of training demonstrated that the specialist training needs of the staff, in addition to health and safety related training is being provided. Feedback from completed staff questionnaires and conversations with staff during the inspection was all very positive and provided further evidence that the staff feel well supported both by management and by the staff team. All but one of the care staff have completed or are working towards gaining National Vocational Qualifications in Care. An inspection of the staff rotas showed that both the day and night staffing are maintained at a level that is appropriate for the needs of the service user. The rotas should include the job titles to provide clarification of the staffs roles. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users can be confident that the manager is well qualified, experienced and well supported and that the service is safely maintained. EVIDENCE: The registered manager has completed her NVQ in Care at Level 4 and Registered Managers Award and has a University Certificate in Autistic Spectrum Disorders. In addition to this she has completed a number of courses in health and safety related and specialist areas and is appropriately trained to provide some of the staff training. As the service has only been registered for six months, an annual quality assurance/quality monitoring review has not yet taken place. Conversations Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 20 with the manager confirmed that such a review is being planned. Regular visits are being carried out on behalf of the registered service providers and records are kept of these visits. All of the required and recommended policies and procedures for the safe running of the home have been written up and are contained in files which are kept accessible to the staff. Records were seen to demonstrate that they staff are reading these documents and signing state when they read them and that they have understood their contents. Records were seen to demonstrate that the provision of health and safety related training both during staff induction and on an on-going basis is good. The home is safely maintained and meets the current safety legislation. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5 Requirement The registered persons must provide each service user with a copy of the Service Users’ Guide. This document should be personalised and written in a format that is accessible to the service user. Timescale for action 06/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA20 YA32 Good Practice Recommendations Medication needed on a PRN basis could be more clearly identified on the MAR sheets. For clarity job titles should be included on the staff rotas. Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Fairview Lodge DS0000067824.V327381.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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